Rotator Cuff Tears

ROTATOR CUFF TEARS

Most frequent cause of pain and limited mobility of shoulder joint is rotator cuff tear. Rotator cuff tear symptoms may appear immediately after an injury or develop gradually. Rotator cuff tear treatment includes repair of the anatomical integrity of the tendon. Below you may read in details about peculiarities of rotator cuff tear treatment.

Your shoulder joint is kept in place by the Rotator Cuff. The Rotator Cuff ensures that your upper arm stays in your shoulder socket, by covering the top upper arm with four muscles and attaching your upper arm to the shoulder blade. This enables you to lift and rotate your arm.
The Bursa is a sac filled with fluid that acts like a cushion between the Rotator Cuff and the top bone of your shoulder often called Acromion. This lubricating sac allows your shoulder joint to glide smoothly when you move your arm. Often a tear in the Rotator Cuff leads to inflammation of the Bursa.

WHAT CAUSES ROTATOR CUFF TEARS?

An acute or traumatic tear in the Rotator Cuff is often a result of a fall. It causes extreme pain and instant weakness of your arm, especially your upper arm. As a result of overuse, a tear in the Rotator Cuff can also cause gradual or chronic pain in the shoulder joint. Initially a tear can be mildly painful when you are using your arm. But, over time, the pain can become even noticeable at rest.

ROTATOR CUFF TEAR SYMPTOMS

The symptoms for both acute and chronic Rotator Cuff tear include:

Feeling pain while lifting or rotating your arm.

Weakened upper arm, specifically while lifting or rotating your arm.

Painful at rest, especially when sleeping on the affected shoulder.

Grinding, clicking or popping sounds (known as Crepitus) while moving the shoulder.

ROTATOR CUFF TEAR TREATMENT

NON-SURGICAL TREATMENT OPTIONS FOR ROTATOR CUFF TEARS

Exhaust all non-surgical treatment, before considering surgical treatment. The best remedy for Rotator Cuff is by allowing the shoulder joint to rest, icing the tender area and doing physical therapy. If the injury is more serious and involves an actual tear of the muscle or tendon, other treatment or surgery might be needed. Options for non-surgical treatment include:

Physical Therapy: Improving flexibility and strengthening the shoulder with physical therapy is essential. In some cases, you can avoid surgery with physical therapy by restoring full functionality and eliminating pain completely.

Steroid Injections: Steroid injections can be considered as a solution if conservative treatments haven’t reduced your pain. A steroid injection is administered into your shoulder joint to reduce the pain. Especially, if the pain is interrupting your sleep or other daily activities. Although steroid shots provide short-term release, it should not be performed too often, as steroid shots will weaken your tendon.

SURGICAL ROTATOR CUFF TEAR TREATMENT

Repairing your torn Rotator Cuff usually means reconnecting the tendon to the top of your upper arm (the head of the humerus). There are a few different surgeries that can repair a Rotator Cuff tear. Here are the two most common options:

Shoulder arthroscopy (keyhole surgery): During this surgery, a small camera will be inserted to repair the tear. When the tear is bigger than expected, a small incision will be made. This surgery requires general anesthesia and the estimated recovery time is two to three weeks during which you will have to wear a sling.

Open tendon repair: An Open Tendon Repair is more suitable for more complex surgeries and usually needs a longer time to recover. Similarly, the goal of this surgery is to re-connect the tendon to the top of the humerus.

REHABILITATION AFTER SURGICAL TREATMENT FOR A ROTATOR CUFF TEAR

Rehabilitation is essential for full recovery, regardless if you have undergone a surgery or not. A program will be provided to strengthen your shoulder and help you to gain more mobility.

After-surgery rehabilitation program will initially focus on the mobility of the shoulder joint and the surrounding muscles. The second focus area for the program is to gain strength and to protect the new ligament. Finally the program will focus on specific functionalities that one requires for their specific needs.

Rehabilitation plays an important role in getting you back to your daily activities. An exercise program will help you regain shoulder strength and motion. Your surgeon will develop a rehabilitation plan based on the surgical procedures you required.

If you have had a more complicated surgical repair, your surgeon may recommend a physical therapist to supervise your exercise program.

It is important that you make a strong effort at rehabilitation in order for your surgery to succeed.

DIAGNOSING A ROTATOR CUFF TEAR

History taking: An examination on recent injuries, current use of medications, your medical and your family’s medical history.

Physical examination: A thorough physical examination of your shoulder joint to diagnose the Rotator Cuff tear. Your doctor will move your arm in all directions to get a clear picture of what triggers the pain.

X-rays:This will provide additional information on the bone condition.

Magnetic Resonance Imaging (MRI): MRI is used to provide more information on the patient’s situation, as it produces a better image that includes bones, cartilage and other soft tissues. An MRI will show the tear of the rotator cuff in more detail.

Arthrogram: With a special dye injected into the joint, an X-ray or MRI is made to allow an even more enhanced image of the shoulder joint.

Arthroscopy: During this minimally invasive surgical procedure, a small camera will be inserted into the joint. This surgery is often only performed, when your doctor expects you to need a surgical repair.